How Does Monkeypox Spread?

Transmission typically involves skin-to-skin contact, but the virus can also linger on surfaces
A medical illustration of the monkeypox virus in purple and pink.

Terms such as “outbreak” and “public health emergency” appear regularly in headlines about monkeypox. Every day seems to bring news of rising case counts — maybe even in your hometown.

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It’s enough to leave you worried and wondering whether you’re at risk of getting randomly infected by the virus. How exactly does monkeypox spread? And is this another COVID-19 situation?

For answers, we turn to infectious disease specialist Kristin Englund, MD.

How monkeypox spreads

Monkeypox can be transmitted in a number of different ways, but it’s most commonly passed between people through skin-to-skin contact, explains Dr. Englund.

A primary symptom of the disease is a skin rash that builds into pus-filled blisters before crusting over. You’re at risk of getting monkeypox if you touch or rub against those sores or scabs on a person who is infected.

The virus can also spread through bodily fluids exchanged during more intimate and prolonged physical contact, such as kissing, cuddling or sex.

“In general, it’s going to take close contact for monkeypox to be spread,” says Dr. Englund.

Is monkeypox spread through the air?

Monkeypox isn’t considered an airborne virus spread through a cough, sneeze or talking. But research on that is ongoing, according to the Centers for Disease Control and Prevention (CDC).

“At this point, we don’t believe it’s being passed through respiratory secretions like we talked about so much with COVID-19,” says Dr. Englund.

As a precaution, though, the CDC recommends that people with monkeypox wear a mask when in close contact with others while isolating at home. Ditto for those near the person who is infected for more than a brief encounter.

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Can you get monkeypox from a contaminated object?

It’s possible … but this answer deserves a more detailed explanation to really understand the potential risk, says Dr. Englund.

Let’s start with the basics: The CDC reports that the monkeypox virus can survive as long as 15 days on surfaces. That’s not a surprise. Other viruses closely related to monkeypox have been found to survive in an environment for weeks or even months.

But here’s the question: Does that present a high risk to you as you go through your daily activities?

The answer: It’s doubtful.

“Monkeypox isn’t something that’s spreading from handling mail or going to the grocery store and putting your hands on a cart,” notes Dr. Englund. “It’s going to take more prolonged and more direct contact for the virus to be shared.”

Now, if you’re living with someone with monkeypox, the risk level obviously rises and it’s best to be cautious. The CDC recommendations include:

  • Not handling bedding, towels or clothing of a person who’s infected. (All of those items would have been in contact with sores or scabs.)
  • Not sharing eating utensils or cups with someone who has monkeypox.
  • Regularly washing and disinfecting items and surfaces in direct contact with a person’s infected skin. (Consider steam cleaning soft surfaces such as furniture, rugs, carpets and mattresses if there was prolonged contact.)
  • Wearing gloves when cleaning or handling potentially contaminated areas or items.
  • Keeping your hands clean by using an alcohol-based hand rub (preferred) or soap and water.

Tips to avoid monkeypox

The CDC offers three basic recommendations to protect yourself during the monkeypox outbreak:

  1. Avoid skin-to-skin contact with anyone who has a rash that looks like monkeypox. (Learn more about monkeypox and safe sex guidelines.)
  2. Avoid contact with clothing, blankets, eating utensils, cups and other items used by someone with monkeypox.
  3. Wash your hands often.

Animal-to-person transmission

Believe it or not, the current outbreak is the second reported in the United States. The first occurred in 2003, with 47 cases reported in the Midwest. (That was the first time human monkeypox was found outside of Africa, where the disease was discovered in 1958.)

All of the 2003 cases stemmed from contact with pet prairie dogs, which were infected after being housed near animals imported from Ghana that had the virus.

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A person can get monkeypox from an infected animal through:

  • Bites.
  • Scratches.
  • Contact with sores, blood or bodily fluids.

It should be noted, too, that there has been a reported case of a human giving their pet dog monkeypox. Dr. Englund says it’s recommended that anyone with monkeypox stay away from household pets while infected.

Is there a monkeypox vaccine?

There is a monkeypox vaccine, but supplies are extremely limited. Given the low supplies, the CDC recommends that available monkeypox vaccines be directed to people who’ve been exposed to the virus or are more likely to get the virus.

The U.S. Food and Drug Administration (FDA) took action in August to change how the vaccine is administered to increase the number of available doses.

Monkeypox has also been seen in a somewhat limited group — primarily, men who have sex with men — during the outbreak. But it should also be noted that the disease isn’t limited to one population.

“At this point in time, though, the general population does not need to go out and get the monkeypox vaccine,” says Dr. Englund.

Is monkeypox a COVID-19 situation?

In a word, no. “Monkeypox is not nearly as easily spread as COVID-19,” states Dr. Englund. “We’re not looking at a repeat of what we’ve been living through with the pandemic over the last few years.”

Still, she emphasizes that it’s important to be aware of monkeypox and whether there are elevated case counts in your community. “Educate yourself on the risks,” she advises, “but it’s not something that should bring a panic.”

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